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A BILL TO BE ENTITLED
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AN ACT
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relating to the establishment of the case assistance affiliate |
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program to provide certain assistance to Medicaid recipients and |
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child health plan program enrollees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 531, Government Code, is amended by |
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adding Subchapter T to read as follows: |
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SUBCHAPTER T. CASE ASSISTANCE AFFILIATE PROGRAM |
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Sec. 531.801. DEFINITIONS. In this subchapter: |
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(1) "Case assistance affiliate" means a managed care |
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organization or dental maintenance organization that participates |
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in the program by assisting Medicaid recipients and child health |
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plan program enrollees by providing application and renewal |
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assistance and benefit case management services. |
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(2) "Case assistant" means an employee of a case |
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assistance affiliate who directly provides application and renewal |
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assistance and benefit case management services to a recipient or |
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enrollee. |
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(3) "Enrollee" means an individual enrolled in the |
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child health plan program. |
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(4) "Program" means the case assistance affiliate |
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program established under this subchapter. |
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(5) "Program manager" means the employee of a case |
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assistance affiliate who is designated by the affiliate to oversee: |
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(A) case assistants; and |
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(B) the application and renewal assistance |
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activities and benefit case management services provided by the |
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affiliate under the program. |
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(6) "Recipient" means a Medicaid recipient. |
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(7) "Virtual case assistance website" means an |
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Internet website described by Section 531.803. |
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Sec. 531.802. ESTABLISHMENT OF CASE ASSISTANCE AFFILIATE |
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PROGRAM. (a) The commission shall: |
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(1) establish a statewide case assistance affiliate |
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program under which managed care organizations and dental |
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maintenance organizations that participate in Medicaid or the child |
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health plan program are allowed to operate as case assistance |
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affiliates by maintaining virtual case assistance websites; and |
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(2) provide a training and certification process for |
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program managers and case assistants providing services under the |
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program. |
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(b) In establishing the program, the commission: |
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(1) shall consult with: |
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(A) experts, as determined by the commission; and |
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(B) other interested persons, including managed |
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care organizations and dental maintenance organizations |
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participating in Medicaid or the child health plan program; and |
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(2) may establish a work group or advisory committee |
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that includes interested persons to advise the commission on the |
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establishment of the program. |
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Sec. 531.803. VIRTUAL CASE ASSISTANCE WEBSITES. (a) A case |
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assistance affiliate shall establish and maintain Internet |
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websites for purposes of providing virtual application and renewal |
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assistance and benefit case management services to the recipients |
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and enrollees served by those organizations. |
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(b) In providing benefit case management services, a case |
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assistance affiliate may use its virtual case assistance website to |
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assist a recipient or enrollee with applying for and managing the |
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recipient's or enrollee's benefits under other public assistance |
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programs, including nutritional and financial assistance benefits. |
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(c) The commission shall ensure that a virtual case |
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assistance website allows a recipient or enrollee to access the |
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website from any electronic device that provides Internet access. |
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Sec. 531.804. ADMINISTRATIVE EXPENSE. The commission shall |
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allow a case assistance affiliate to categorize the services the |
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affiliate provides under the program as administrative expenses. |
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Sec. 531.805. RULES: PROGRAM REQUIREMENTS AND STANDARDS. |
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The executive commissioner shall adopt rules necessary to implement |
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the program, including rules: |
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(1) establishing requirements for a managed care |
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organization or dental maintenance organization to participate in |
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the program; |
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(2) establishing the training and certification |
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process required by Section 531.802(a)(2); |
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(3) providing for the suspension, revocation, and, as |
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appropriate, periodic renewal of a case assistant's or program |
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manager's certification; |
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(4) protecting the confidentiality of recipients' and |
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enrollees' information; and |
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(5) establishing any other standards or requirements |
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the executive commissioner determines necessary. |
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SECTION 2. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 3. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2023. |